Abstract
Background
Temporomandibular joint ankylosis-associated deformity and dysfunction is a challenge to reconstruct. Alloplastic temporomandibular joints, both stock and custom-made, are used to replace the ankylotic mass with a functional joint. Still, the cost of these alloplastic joints is so expensive that it cannot be affordable to most of our population.
Purpose
A primary objective of achieving at least 35 mm of mouth opening was planned. Secondarily we planned to achieve a functional occlusion with acceptable facial balance and symmetry.
Method
Autologous TMJ reconstruction using vascularized second metatarsal joint transfer with concomitant orthognathic surgery. The surgery aims to achieve a significant functional rehabilitation with correction of maxillomandibular deformity in a single-stage surgery.
Results
As a result of this, we present our initial experience to rehabilitate the patient with temporomandibular joint ankylosis both functionally and aesthetically by performing simultaneously joint replacement using the patient’s own vascularized second metatarsal joint and concomitantly performing the orthognathic surgery. By this, we could holistically treat the patient with minimal cost and make them socially acceptable.
Conclusion
We do not propose a 2nd metatarsal vascularized flap as a substitute for a custom-made total TMJ prosthesis. Still, we suggest a viable option in a selected set of patients where TMJ prosthesis cannot be afforded or has failed with a history of multiple surgeries in the same region.
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Acknowledgements
I thank Dr Ajoy Roychoudary, Head, Division of Oral & Maxillofacial Surgery, CDER, AIIMS New Delhi, for guiding me through the principles of TMJ reconstruction and application of the same in this study.
Funding
The study is funded by All India Institute of Medical Sciences (AIIMS), Raipur, under the intra mural grants.
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An institute ethical clearance was obtained with reference no 547/IEC-AIIMSRPR/2018.
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An institute ethical clearance was obtained with reference no 547/IEC-AIIMSRPR/2018.
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Rao, S., Pandey, S., Konuri, V.K. et al. Vascularized Second Metatarsal Joint Transfer with Concomitant Orthognathic Surgery for Reconstruction of the Temporomandibular Joint: Our Pilot Experience. J. Maxillofac. Oral Surg. 21, 58–63 (2022). https://doi.org/10.1007/s12663-021-01615-z
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DOI: https://doi.org/10.1007/s12663-021-01615-z